Polycystic Kidney Disease

Polycystic kidney disease (PKD) is the most common inherited cause of kidney failure in adults. It is genetically acquired and has two forms – the dominant and the recessive form. Most adults with PKD have the dominant form. Recessive form causes problems much earlier (during childhood) and life expectancy is usually not beyond the teenage years.

In the dominant PKD form, one parent has the disease and passes it to the child. The chance of passing the gene to the offspring is 50%. There are instances of spontaneous genetic mutations whereby the parents do not carry the flawed gene but the offspring is still afflicted with the condition. This genetic flaw causes the development of multiple cysts to evolve from the nephrons. Cysts are abnormal pouches containing fluid. Eventually the cysts replace normal kidney tissue and the person with this condition suffers kidney failure. Cysts also develop in the liver and pancreas.

Signs and Symptoms

Dull pain at the side of the abdomen (flank) and back

Blood in the urine

Frequent urine tract infection

High blood pressure / Hypertension (often before cysts appear)

Upper abdominal discomfort (liver and pancreatic cysts)

Treatment

Treatment options vary depending on the existing problem:

Blood pressure – must be controlled and treated

Kidney failure – supportive therapy until end-stage is reached when dialysis or transplant is then required

Urine tract infection – treatment with antibiotics

Pain – analgesics (pain-killers) are used. If intractable, surgery to shrink or resect the cysts may be necessary

Headache – caution is necessary because this condition is associated with aneurysm of blood vessels in the brain (abnormally dilated blood vessels) that can rupture and cause bleeding in the brain

As the condition is associated with abnormal genetic material, there is no known cure or preventive strategy at present. This commonly occurring condition is quite different from a condition known as simple kidney cysts. These (simple cysts) can be single or multiple (may be mistaken for PKD). Simple cysts rarely cause symptoms and do not harm the kidneys. It may however cause pain or elevated blood pressure.

Resources

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As the largest kidney foundation in Singapore, NKF promotes kidney transplant and provides quality, highly subsidised dialysis treatment and holistic care. We also encourage and empower the community to take charge of their health through education and prevention of kidney disease.